Neuroscientists have emphasized visceral influences on consciousness and attention, but the potential neurophysiological pathways remain under exploration. Here, we found two neurophysiological pathways of heart-brain interaction based on the relationship between oxygen-transport by red blood cells (RBCs) and consciousness/attention. To this end, we collected a dataset based on the routine physical examination, the breaking continuous flash suppression (b-CFS) paradigm, and an attention network test (ANT) in 140 immigrants under the hypoxic Tibetan environment. We combined electroencephalography and multilevel mediation analysis to investigate the relationship between RBC properties and consciousness/attention. The results showed that RBC function, via two independent neurophysiological pathways, not only triggered interoceptive re-representations in the insula and awareness connected to orienting attention but also induced an immune response corresponding to consciousness and executive control. Importantly, consciousness played a fundamental role in executive function which might be associated with the level of perceived stress. These results indicated the important role of oxygen-transport in heart-brain interactions, in which the related stress response affected consciousness and executive control. The findings provide new insights into the neurophysiological schema of heart-brain interactions.

神经科学家强调了对意识和注意力的本能影响，但潜在的神经生理学途径仍在探索中。在这里，我们基于红细胞 (RBC) 的氧气运输与意识/注意力之间的关系，发现了两种心脑相互作用的神经生理学途径。为此，我们在低氧藏族环境下收集了 140 名移民的常规体格检查、打破连续闪光抑制 (b-CFS) 范式和注意力网络测试 (ANT) 的数据集。我们结合脑电图和多级中介分析来研究红细胞特性与意识/注意力之间的关系。结果表明，RBC 功能通过两条独立的神经生理通路，不仅触发了脑岛的内感受再表征和与定向注意力相关的意识，而且还诱导了与意识和执行控制相对应的免疫反应。重要的是，意识在执行功能中发挥着重要作用，这可能与感知压力的水平有关。这些结果表明氧运输在心脑相互作用中的重要作用，其中相关的压力反应影响意识和执行控制。这些发现为心脑相互作用的神经生理学模式提供了新的见解。